Individual
MRS. MARY-ANNE JEAN CASTONGUAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
113 QUEBEC STREET, W.G. MALLETT SCHOOL, FARMINGTON, ME 04938-7039
(207) 778-3529
Mailing address
115 LEARNING LANE, RSU #9 DBA MT. BLUE REGIONAL SCHOOL DISTRICT, FARMINGTON, ME 04938-7039
(207) 778-9517
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
12092107
ME
235Z00000X
Speech-Language Pathologist
Primary
SP1206
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE NUMBER: 1209
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
ME
01
—
SP1206
STATE OF MAINE, BOARD OF SPEECH-LANGUAGE PATHOLOGY
ME
Enumeration date
09/15/2010
Last updated
09/15/2010
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